Doctor’s Data and Bogus Tests

This week in The Lawyer, Robert Dougans and David Allen Green wrote about the emerging phenomenon of ‘wiki litigation’ where there is large scale scrutiny and participation in legal proceedings using the web as a shared medium. They used the example of the British Chiropractic Association’s libel case against science writer Simon Singh. This was not just the web watching the case – but actively participating by the scrutiny of all parts of the claim, actively playing out scenarios and options for Singh, and undertaking a distributed analysis of the pertinent scientific points – the result being the demolition of the BCA’s reputation.

This mass participation turned a near hopeless case for Singh under the absurd English libel system into a victory and a total humiliation for the chiropractors. It was a great example of what Clay Shirky describes in his book Here Comes Everybody of how the internet can bring together like minded people to collaborate on creating previously unthinkable change.

It is likely that a US company called Doctor’s Data (DDI) is going to be facing similar scrutiny as it is has decided to sue the website Quackwatch for libel. Stephen Barrett has been very critical of DDI and has written that the diagnostic health tests it provides are used to defraud patients. One test in particular stood out for his criticism where patients are given a “provoking agent” that flushes out heavy metals into the urine. A urine test is then analysed by DDI and the concentration of heavy metals is compared with standards. Except the standards used are for patients who have not had the provoking agent. The levels of metals are going to be much higher than normal and this ‘elevated result’ is then used to sell expensive and unnecessary treatments. These tests are particularly popular with doctors in the US who advocate chelation for the treatment of autism. It is a bogus treatment and such laboratory tests provide an artificial sense of urgency and validation.

Doctor’s Data asked Stephen Barrett to remove his articles discussing these urine tests as they were “false, fraudulent, defamatory or otherwise not truthful”. Dr Barrett replied asking for clarification as to what specifically he had written that was not correct or fair opinion. Doctor’s Data did not respond but instead has now simply filed suit.

This is tragically familiar. When the Society of Homeopaths threatened me, I asked them to detail their concerns. I got no response. The chiropractors also asserted they had a ‘plethora’ of evidence to back up their claims when they sued Simon Singh. They withheld the plethora – and when it was finally released, it was quickly shown to be worth nothing.

I can confidently label these treatments as bogus because I have researched and written about some of them before.

Pursuing a court case rather than discussing evidence does not make Doctor’s Data look the good guys in this episode. Quackwatch would appear to have some very serious concerns about how their tests are used to mislead people into expensive and unnecessary treatments. If DDI could defend the selling of these tests against these complaints then it is surprising that they do not. Looking at their web site, Doctor’s Data would appear to be a respectable laboratory and yet they happily promote a number of bogus tests.

I can confidently label these treatments as bogus because I have researched and written about some of them before. DDI also offer Hair Analysis as a way of assessing nutritional status. This is simply not possible to do in any meaningful way. As I have explained, to measure the mineral content of hair and then draw conclusions that lead to intervention recommendations (such as supplementing with pills) is not possible given the state of knowledge we have about how hair mineral levels relate to possible deficiencies. And yet, this is precisely what nutritionists do. They use these tests to give scientific plausibility to their recommendations and their customers purchase expensive supplements ‘tailored’ to their ‘nutritional status’ as revealed by the tests.

And if we in the UK think this a peculiar US phenomenon, we should note that DDI operate in Europe too. Their testimonial page for their “comprehensive testing for the treatment of autism” offers some feedback from “luminaries in this field of medicine.”

Dr Munro is not unknown to the Quackometer. We have seen how the private hospital treats people with ‘electrosensitivity’ (a condition where people falsely attribute symptoms such as headaches to the presence of mobile phones and mains cabling) by subjecting them to strange Eastern European magnetic therapy devices and using unreliable diagnostic tests to see if things are ‘working’. I have also documented how Breakspear treats allergies with special injections on the basis of bizarre, pseodoscientific and homeopathic reasoning.

Breakspear also offers treatments for autism. Part of this expensive programme is chelation to remove supposed high levels of heavy metals. Breakspear states that it regularly tests urine during chelation to look at metal levels – precisely the sort test that is at issue here. Breakspear tell us that the test is “evaluated at independent accredited laboratories”.

In Jean Munro’s testimony on the DDI web page she says,

Breakspear Hospital and its antecedents have been practicing in the field of environmental medicine, allergy and nutritional medicine since the late 1970s. Throughout this entire period we have worked with Doctor’s Data Inc. Stool tests and investigations for heavy metals through urine tests have been the mainstays of our management of patients. The service we receive is excellent with results set out superbly and with expert advice available from Doctor’s Data’s scientific advisors whenever requested. Having had this experience and backup, we can now provide a service to any practitioner in the UK, including practitioners helping to treat children on the autistic spectrum and patients with Aspergers syndrome who will benefit from this laboratory service.

Munro does not hide the central importance of urine testing in the “management of patients”.

In 1990 Granada Television’s ‘World in Action’ programme produced a documentary that focused on the activities of Dr Monro and the Breakspear hospital. The programme alleged that the Breakspear Hospital in Hertfordshire has been “the subject of allegations of wrong diagnosis, useless treatment and a death following the failure of treatments. It is run by Dr Jean Monro who charges extortionate fees for bizarre treatments.”

Munro sued.

The programme makers had to apologise for stating that Munro took “wrongful advantage of her patients’ vulnerability”. Their other charges stood.

The problem with many libel cases in the UK is that you are often as a defendant pushed into proving a state of mind, much as Simon Singh nearly had to. To show that Munro deliberately misleads and defrauds requires an impossible peering into her soul to understand her motives. An aggrieved party can always claim that they are honestly going about their business, even if the subsequent analysis of the science or facts may prove them wrong. Being wrong but honest is not the same as being fraudulent.

Being wrong but honest is not the same as being fraudulent.

And that is the problem that Quackwatch may face, if any. Barrett has stated that these tests are used to defraud patients. But it is quite possible, and indeed we must assume for the moment, that all people involved are acting with what they believe to be honesty. The laboratory may well be offering analytical tests to the best of their ability. It is not up to the laboratory to dictate how doctors use the data. The doctors and nutritionists who use the tests may be mistakenly using them to spot deficiencies, excesses and problems that need correcting. They may well have been trained to interpret the tests in inappropriate ways. The end result, however, is indistinguishable from fraud. Patients are being falsely led to believe they have a problem that needs expensive intervention to correct. They may hand over thousands of dollars as a result of being misled.

Patients are being badly let down by regulatory authorities and governments that allow this chain of deception (intentional or otherwise) to take place.

We can see another clear UK example from the Doctor’s Data web site where. One other “luminary” is a Nutritional Therapist called Antony J. Haynes BA(Hons), Dip ION from London. Haynes says of the lab,

In my professional opinion, Doctor’s Data, Inc. (DDI) not only offers an excellent service, but also has the finest and most up-to-date scientific laboratory assessments available anywhere. DDI’s elemental, amino acid and comprehensive stool analysis test results have proven invaluable in helping offer the most appropriate therapy to those with ASD. I’d recommend DDI to colleagues and patients alike.

Haynes appears to work for a nutritional supplement company, lectures in many undergraduate colleges and has had over 11,000 ‘patients’. He states that he is registered with the Complementary & Natural Healthcare Council (Ofquack) although I cannot find his name on their list. (Although to be fair, I have little faith in Ofquack’s IT skills). He was trained at Patrick Holford’s ION where hair mineral analysis is taught as a legitimate technique for assessing nutrient needs. Haynes is not alone. It is quite possible to find people on Ofquack’s register who do undertake such tests and then sell pills on the back of these meaningless results.

And here is where the real failure is. Ofquack does not see such misleading claims as an impairment to fitness to practice. As Simon Perry uncovered, it appears to be acceptable for such claims to be made if they have been trained to do so and that no deliberate attempt to mislead has been made. The best that the government can do in protecting people from dodgy tests is to set up a voluntary registration body that feels it cannot tell someone off if they have been told to do the tests by bigger boys and girls.

Yes, it is true that very few people or places provide the type of information that [Barrett] does. That’s why I linked to so many of his articles from my own recent post. You can’t find that kind of information on virtually any mainstream website that claims to give reliable information about “complementary and alternative medicine”: not on WebMD, not onInteliHealth, not on the NCCAM website—even though most people would probably expect to find it in those places, if they were aware of it at all. You won’t find on any of those sites, for example, that being “a CLlA-certified company in full compliance with all state and federal regulatory and CLlA standards” is no guarantee against peddling bogus diagnostic tests.

It is a scandal that Quackwatch has had to highlight these concerns nearly alone. Barrett is now paying the price of speaking out. And he is one of the few voices warning the public to be aware. Stephen Barrett deserves to be supported. You can donate here.

More importantly, let Doctor’s Data know that deciding to sue without addressing the science is not a risk free and low cost option for shutting up critics. Write about the case. Examine its merits. Blog. Tweet. Comment. These tests are a menace and largely unregulated. Perhaps DDIs actions could shine some unexpected light into this murky world, and maybe, just maybe, someone will be watching.

29 Comments on Doctor’s Data and Bogus Tests

I don’t know much about libel laws.
Am I right in assuming you could not get sued for libel if you just avoided saying anything about a person’s motivations and just reported bald facts?
If so, why don’t critics do just that?
You can say a great deal that would lead most people to draw the inference that someone is dishonest without actually saying it.
And at the end of the day it is less important whether a promoter of a quack treatment does it because they genuinely believe in it, than whether their claims have any merit.

One of the problems, Dorothy, is that (I assume) the case isn’t actually tested until it gets to court. In the meantime you have to gather your data, probably engage a lawyer and possibly postpone more important work in order to make sure your case convinces the judge of the weaknesses of the suit. How many people are committed enough to be bothered?

As for what constitutes libel, it differs around the world.

It’s completely ridiculous that government’s the world over just turn a blind eye to some of the most egregious frauds committed in the name of “wellness”. That bloggers have to put themselves at risk for the sake of the wider community is pathetic.

“…In summary, this test has not been validated and there is a body of literature (see references cited above) which indicate that in blinded studies, it is of little value in diagnosing and treating allergic disease …”

Dr Lieberman (AAAAI) also recommends:
“…A further, very nice review of this testing procedure can be found on the Internet. Please go to the site “Quack Watch” and you will find an article by Dr. Stephen Barrett which summarizes the studies of this technique…”

I support Simon Singh and Quackwatch and I do believe that there is no doubt in the minds of all persons associated with these tests that the patients are paying up heavily for something they wrongly believe in.

However, I wonder if it is necessary to publicise the matter as a fraud. I am just getting involved and have not much experience, and I can readily accept that calling something a ‘fraud’ is a quick and dirty way to draw attention adverse attention to it.

On the other hand, publicising with circumspection could leave many readers to draw the conclusion of ‘fraud’ on their own, and the majority may never get there. People do need to be spoon fed with stuff.

I think even without knowing or saying anything about heavy metal toxicity, it is highly dubious of Doctor’s Data to compare what they find in a provoked urine test to reference values meant for unprovoked tests.

To put this more bluntly, this is like breaking eggs in the supermarket and then complaining to the staff that they sell broken eggs.

I support Quackwatch and I would urge others to do so… use the PayPal link and give some money!

If anyone reading Quackwatch articles disagrees with their content, they are free to stop reading and never come back. They are also free to comment. QW provides an essential balance against pseudo science.

Doctor’s Data and Breakspear may may sincerely believe in what they are doing, or they may not. If there is no data to support what they are selling as certainty then it really doesn’t matter; it is fraud or delusion.

If regulators won’t tackle this issue, then citizens have a right to balance.

Many heavy metals BIND to tissues. They do not circulate in the blood, to be removed by the kidneys into the urine, except for maybe a few days to a couple weeks. After that, urine or blood can’t reveal true poisoning or toxicity. Without provoked testing, you have no idea of heavy metals burden–unless poisoned the day before the test. The reference level is non-provoked, because you shouldn’t have poisons your body can’t remove.

Doctors Data toxic metals tests were especially useful as a GUIDE to how much mercury I had & how efficiently my body was eliminating it. This was supervised by a qualified professional–an ND who is NOT a quack. Mercury toxicity is a serious issue which most MDs don’t take seriously. MDs don’t have all the answers. There will always be charlatans, & many of them are MDs. Does Barrett write about them???

Although I will whole heartedly agree with you that there are many charlatans trying to defraud peaople and take advantage of their problems offering unsubstatiated treatments, I think you are doing just the same, only in an oposite direction. No scietific proof does not mean that something does not work, it only means it has not been proven by the scientific community. It is adsurd to claim that alternative medicine doen not offer any benefits and Homeopathy is a hoax. Heavy metal toxicity does exist and, although current dignostic tests may not be as effective as they should and Chelation therapy may or may not treat this poisoning, it should not be called a “quack”. On the contrary, scientists should pool together to find solutions to these so complex issues instead of looking after their own interests and profiting from a pharmaceutically led industry.

I would also like to ask what evidence do you have that proves alternative medicine and practitioners are charlatans, and by evidence i do not mean your own opinions. At the end of the day, you are acusing these people of not having “scientifically based evidence”, you should have the same otherwise the “quack is on you”.

Dear Steve, Please re-read my post – and my blog in general. I rarely assert that someone is a ‘charlatan’. Most people in alt med are sincere believers – quackery is far more interesting than mere unscrupulous deception.

You are right that no scientific proof does not mean that something does not work – it means we do not know if it does work. If you then sell a product or service without good evidence then you risk harming people. That is quackery. You are obviously confused as to what scientists do – as indeed they do work together to look for solutions to health problems.

Dear Mr. Lewis, I can assure you I am not at all confused as to what scientists do, being a medical practitioner myself. I do not believe in western medicine and I do not believe in alternative medicine because they both have one fundamental flaw, they are both interested in making money instead of being interested in curing people. In university (1988) I was taught that only 35 illnesses can be cured 100%, for the rest we can only cure the symptoms, inhibit the process of disease, or live with, often, serious complications. To me, this is a very poor track record and, as such, western medicine should “tone down” a bit and start listening to traditional medicine in a possibility to actually marry the benefits of both and maybe cure some people their problems.

I am too tired of watching my pompous colleagues in lectures and congresses try to outsmart each other and prove just how brilliant they are, too tired of hearing them talk about patients in terminal states as “interesting cases” and then drive off in their luxury cars to their dinner parties.

On the other hand, I agree with you about all the nutritionists, homeopaths, naturalist, e.t.c. flukes who only what to be caliphs in place of the caliph, if you understand what I mean. I would, for once, like to see someone actually interested in treating people rather than trying to prove to each other that’s right (what you are trying to do with this site). I you could only divert your hard work and energy to find a solution to so many peoples’ problems, people who are suffering because their children are “diagnosed” with incurable diseases such as tourettes, ADHD, OCD, autism e.t.c. Traditional medicine does not have the answers and alternative only knows to accuse, what is your answer to all those suffering parents and children?

In response to your comments on heavy metal testing, I agree 100% on the lack of reliability of testing hair. However, your criticism of testing on urine thru the use of a chelating agent is totally unfounded. You talk about ‘standard control ranges’ being fraudolently used to show artificially higher levels as produced by the chelating agent. But you omit to say that we should not have heavy metals in our body, by and large, certainly not mercury or aluminium or cadmium etc. Which makes me question how much biochemistry you actually know to give yourself permission to criticize these tests accurately. The reason for using a chelating agent is that the organic molecular composition of such metals in our body is lipophilic, and is primarily stored in fatty tissues. Without a chelating agent, heavy metals do not get “pulled out” of the fatty tissue and will therefore not show as a water-soluble substance filtered by the kidneys into the urine. There are plenty of test results that show negative heavy metal levels in healthy individuals who do not have a heavy metal problem; where the chelating agent shows a positive result, there are usually identifiable symptoms that can be attributed to heavy metal toxicity. I do not know why the people you supposedly “interviewed” about this could not give you this answer as it is a biochemically well known fact. The trouble with standard medical tests is the categorical refusal of the medical profession to evaluate something unless it has become pathological, incurable and irreversible, therefore producing a very nice income for themselves in terms of continued care and for the pharmaceutical industry. As in thyroid disease, where nothing is done until results show a sick thyroid as opposed to warning signs of it becoming sick – typical answer is “we are watching this” – translate into “come back when it’s really bad, then we’ll give you drugs”, instead of educating the patient into making lifestyle changes and utilizing supplements to reverse an early non-pathological condition where possible and where proper research supports the claims of such supplements (such as using selenium where deficient to improve thyroid function, for example). Get your facts straight.

If so, I can understand your many misunderstandings. Osteopaths are taught to believe that have had a scientific education. What you are actually taught is pseudoscientific justifications to use in selling treatments. You are ‘scientificky’ not scientific.

In science, proper controls are always required. Using inappropriate controls will give you meaningless results. It’s that simple. There will always be some trace level of metals in the body. Chelation flushes these out and allows quacks to proclaim “this should not be here! Here is my treatment.” I hope you are not one of those people.

As a medical student with a growing interest in toxicology I thought I would offer my 2 cents.

Most individuals would demonstrate a body burden of toxic metals following a provocation challenge.

From a clinical standpoint the paramount issue is whether these findings are of relevance to pathology evident or otherwise.

Inferences drawn from urine analyses without reference values are to be properly described as of tentative value.

Pre-provocation values are of some use in determining the innate capacity of the organism to excrete the body burdern, low levels would permit several conclusions: the total body burden it low, the detoxification capacity of the host is compromised (eg. polymorphism in GS [glutathione synthetase])http://www.springerlink.com/content/m58h118035l804m7/
‘Deep’ sequestration by tissues.

Post-provocation values would be expected to rise in all indivuals following administration of a chelating agent. The relative values depend on the concentration within the body and affinity of chelator for metals. Baseline references cannot be used to determine statistical distribution of the post-provocation values amongst the reference population.

However the findings may still be of clinical following judicious analysis. Calculations may be performed to determine bodily concentrations by manipulating urine concentrations and chelator affinity for examined metal. I am unsure if this regularly performed but may potentially increases the accuracy of the ensuing inference. As an aside It would be prudent to expect the interference of biological modifiers in providing a wholly accurate assessment eg. moderately elevated cadmium in urine does not indicate high tissue burden in the lungs and low burden elsewhere.

One may also compare the elevations of toxic metals relative to one another which would provide a crude but potentially useful indication of body burden. For example if the post-provocation urine mercury was comparatively low to a greatly elevated urine cadmium and aluminium. This would suspicious of substantial exposure to these latter elements or the individual may have had a history of inconsistent exposure to mercury. Bearing in mind mercury in its various forms is ubiquitously distributed in our environment this conclusion would appear less likely. Is a patient in this situation a candidate for chelation therapy? The History identifies the patient as a chronic smoker (Known source of cadmium exposure) and lived several miles away from an incinerator (know source of mercury exposure), and coupled with the urine results it is defensible to proceed with chelation therapy. Note I do not say acceptable or otherwise but introduce the notion of scientific defensibility. Any practice within medicine must be scientifically defensible and pay little heed to ‘expert’ opinion, it is clearly of use with the volumes of information we are exposed but cannot and must not be substituted for careful and considered reasoning. Would an intelligent patient who has spent months researching the literature of a specific cardiovascular abnormality be more competent that his treating physican? I would say in certain areas yes.

Ultimately the issue presented in the article above centres on poor understanding of the requirements for a logical determination. DD poor representation of the use of urinary challenge testing eclipses the greater issue of toxic metal exposure in the pathogenesis of chronic disease.

Stephen Barrett is in big trouble in the Doctor’s Data v Barrett case.

BIG trouble.

You can follow the case at hxxp:www.boleneport.com. There you can sign up for the newsletter, and follow the case as it happens.

Currently Barrett has filed a Motion to Dismiss the case, but there is little chance that will happen. His reason he wants a Dismissal? He claims he is “assisting the government…”

Next comes “discovery,” a process where Barrett will have to cough up thousands of documents, then go into a video-taped Deposition where he will be forced to answer questions about his support network – those that helped him get his articles on the first page of search engines.

Barrett’s lead attorney seems to have disappeared, and he has been LATE making EVERY filing deadline since the case began.

You come across as a bit of a fanatic you know but that seems to be par for the course for quacks and their followers.

I think that it’s very telling that you are relying on Barrett having a dodgy “support network” and breaking down when he is “forced to answer questions” rather than having any faith in DD to come up with any evidence.

The term quack comes from “quicksilver” which is another name for…. wait for it mercury. The term quack was coined for doctors that used mercury in medicine to treat patients so Its highly Ironic that people on here are trying to poo poo the fact that people are still becoming very very Ill from the use of mercury In modern medicine , for instance, mercury fillings , vaccines, preservatives In eye drops and all manner of things all contain mercury, the most toxic poison on earth after plutonium.

There are many people suffering terribly , myself included, a decade ago I had many mercury fillings unsafely drilled out , a week later I was extremely ill and I spent the next 6 years housebound in extreme pain , cognitive problems, extreme fatigue and many other health problems and I am still suffering greatly. They are thousands like me, what are we meant to do?? we know what caused our illness , its common knowledge how toxic mercury is and the effects it has on the human body yet the establishment still fails to recognise our pain.. why?? well because they are the quacks! they give it to us in our medicines and dental work so they aren’t allowed to say anything against it. Which means that people like me turn to doctors that are brave enough to tell the truth and to try to treat us for the poisoning of which the quacks have given us.

Do you really believe that if your gp and your dentist says its true that It is? there are thousands of dentists now that have refused to use mercury any longer, there are whole countries that have banned the use of it in dentistry.

People need to wake up and stop believing everything they are told like sheep then maybe there will be a chance for people like me.

I hope that you never ever have to suffer the pain of mercury poisoning, It is the most terrible illness imaginable and one to which it is extremely difficult to treat, especially with the ignorance of most doctors.

I love the war that has been going on for so long between the ‘alternative’ and mainstream camps. I love how the mainstream camp endlessly avoids the same kind of scrutiny of big pharma and conventional treatments, their effectiveness, damage to patients, the way they are promoted and marketed. People want to delude themselves that the establishment is some nice and accountable system, all with the best interests of scientific discovery and understanding, for the betterment of mankind.

The attacks and questioning of such testing is well warranted, alternative medicine and the supplement industry needs to be kept in check, but it does not mean you throw the baby out with the bathwater. The same scrutiny needs to endlessly be applied to the mainstream, but instead it is overly protected by the system as a whole. Show me on Quackwatch where Barrett has criticized conventional treatment or a pharmaceutical drug, bet you can not find one; the classic bias which leaves the whole scientific community badly wanting.

You are making a calssification error. This site is dedicated to examining superstitious and pseudoscientific health claims. Health claims made by pharma etc are routinely critiqued in many quarters, including scientific journals, public health bodies, doctors, academics etc. It is very much embedded within modern scientific medicine to be critical of claims. What is more, there are campaigns, which I suport, to extend this critical landscape, etc the #AllTrials campaign.

Compare this with the alt med industry – characterised by a complete lack of critical self-appraisal. Can you name any alt med technique or remedy that was withdrawn because of alt med practitioners concerns and examinations?

As for Dr Barrett, I would suggest that his battles with Doctors Data are exactly what you are looking for. Claims made by a company that would like to think of itself as mainstream but in need of very close scrutiny.

Is there an update on the case? I recently read a derogatory blog comment that referred to “the late Steven Barrett” but Wikipedia has no note of Dr Barrett’s passing. Information about progress of the case is non-existent outside of Bolen’s years of occasional rants about how victory is nigh for DD.

If this were really quack watching, why no mention of statins? The entire industry is based on pseudoscientific twaddle. There are numerous scholarly scientific articles online. Barret is an AMA shill, pure and simple.

I had a stool sample show a mercury level extremely high I went to a different dr and paid for a hair sample that showed a normal level within a year when I called to question which was correct.i was told my Dr needs to decide how to treat!really!how can he by thcannot trust thise test results so oppositethe girl just said they tested properly!THEN WHICH TEST IS ACCURATE!!I PAYED FOR BOTH!i cannot trust this lab!